MAGNETIC-RESONANCE-IMAGING CORRELATES OF DEPRESSION IN EARLY-ONSET AND LATE-ONSET ALZHEIMERS-DISEASE

Background: Depressive symptoms are frequent complications of Alzheime r's disease (AD). We hypothesized that AD patients with depression wou ld be more likely than nondepressed AD patients to show deep white-mat ter, subcortical gray-matter, and periventricular hyperintensities on magnetic resonance imaging (MRI). Methods: In a retrospective study of 31 AD patients, depression was characterized by clinical diagnosis (D SM-III-R major depression, depressive symptoms, or no depression), a c linician-rated depression scale, and informant ratings of premorbid (b efore memory disorder) as well as current depression using the NEO Per sonality inventory (NEO-PI), and related to qualitative and quantitati ve ratings of MRI hyperintensities. Results: In contrast to reports in nondemented elderly patients, there was no relationship between clini cal diagnosis of major depressive episode and hyperintensities; howeve r clinician-rated depressive symptoms were higher in subjects with lar ge anterior hyperintensities. In the early-onset AD group only, MRI ab normalities were related to greater premorbid depression, and less inc rease in depression after the onset of dementia, as rated by informant s on the NEO-PI. Conclusions: Results highlight the need to consider e arly- and late-onset AD separately when assessing relationships betwee n personality and MRI abnormalities, and to consider premorbid persona lity style when drawing conclusions about the etiology of depressive f eatures seen in AD. (C) 1998 Society of Biological Psychiatry.